Mandeville Animal Hospital New Client and Patient Form

If you're a new client and/or have a new pet that will be visiting Mandeville Animal Hospital for services or boarding, please fill out the online form below or feel free to download and fill out before your arrival.

New client/patient form

I DO (check) / DO NOT (leave unchecked) authorize the use of my pet’s first name, photograph and clinical information (including
medical condition, treatment and prognosis) on MAH’S website, social media, news media page or within informational pamphlets.

I hearby authorize Dr. Ledet and the sta of Mandeville Animal Hospital to perform examinations, diagnostics, prescribe for, and
treat the above mentioned pet(s). I assume responsibility for all charges incurred for such procedures and treatments. I understand
that these charges must be paid at the time services are rendered and a deposit may be required for certain surgical and medical
treatments.

Thank you! Your submission has been received!

Oops! Something went wrong while submitting the form

boarding agreement

I understand that MAH takes every precaution to provide a safe, healthy environment for pets in their care. Should an injury or
illness occur while my pet is boarded, MAH will make every effort to reach me prior to its treatment. Should MAH be unable to
reach me, I grant MAH permission to provide any necessary health care for my pet. I agree that I release MAH from responsibility
or liability in the event of injury to or onset of illness in my pet while in their care.

I understand that MAH is not open 24-hours and that there will be a period of time overnight in which no staff will be on the
premises.

I also understand that if fleas are found on my pet during its stay, appropriate treatment will be administered at the owner’s
expense.

MAH will not be responsible for any items left that are lost or damaged. Any items that become soiled and are too big to easily
wash in a normal laundry machine will be placed in a bag and sent home soiled. In that case, we will substitute our own bedding
for use while your pet is staying with us. Payment for all services is due upon discharge.